Patient-Reported Receipt of Goal-Concordant Care Among Seriously Ill Outpatients—Prevalence and Associated Factors
| Autor: | J. Randall Curtis, Matthew E. Modes, Erin K. Kross, Susan R. Heckbert, Ruth A. Engelberg, Elizabeth L. Nielsen |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Concordance Psychological intervention Context (language use) Medical care Article Patient Care Planning 03 medical and health sciences 0302 clinical medicine Outpatients Health care Prevalence Humans Medicine Patient Reported Outcome Measures 030212 general & internal medicine General Nursing Receipt business.industry Anesthesiology and Pain Medicine 030220 oncology & carcinogenesis Relative risk Family medicine Neurology (clinical) business Goals |
| Zdroj: | J Pain Symptom Manage |
| ISSN: | 0885-3924 |
| DOI: | 10.1016/j.jpainsymman.2020.04.026 |
| Popis: | Context Goal-concordant care is an important indicator of high-quality care in serious illness. Objectives To estimate the prevalence of patient-reported receipt of goal-concordant care among seriously ill outpatients and identify factors associated with the absence of patient-reported goal concordance. Methods Analysis of enrollment surveys from a multicenter cluster-randomized trial of outpatients with serious illness. Patients reported their prioritized health care goal and the focus of their current medical care; these items were matched to define receipt of goal-concordant care. Results Of 405 patients with a prioritized health care goal, 58% reported receipt of goal-concordant care, 17% goal-discordant care, and 25% were uncertain of the focus of their care. Patient-reported receipt of goal concordance differed by patient goal. For patients who prioritized extending life, 86% reported goal-concordant care, 2% goal-discordant care, and 12% were uncertain of the focus of their care. For patients who prioritized relief of pain and discomfort, 51% reported goal-concordant care, 21% goal-discordant care, and 28% were uncertain of the focus of their care. Patients who prioritized a goal of relief of pain and discomfort were more likely to report goal-discordant care than patients who prioritized a goal of extending life (relative risk ratio 22.20; 95% CI 4.59, 107.38). Conclusion Seriously ill outpatients who prioritize a goal of relief of pain and discomfort are less likely to report receipt of goal-concordant care than patients who prioritize extending life. Future interventions designed to improve receipt of goal-concordant care should focus on identifying patients who prioritize relief of pain and discomfort and promoting care aligned with that goal. |
| Databáze: | OpenAIRE |
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